How Many Timed Units Can I Bill In An Hour?
A question I am often asked is how many 15-minute time-based units can I bill in an hour? Or phrased another way, I can only bill 4 15-minute time-based units in an hour, correct? The simple answer is that it’s possible to bill more than 4 15-minute time-based units in an hour, even if you had an all Medicare outpatient therapy population. In this article, I will provide examples of how it’s possible to bill more than 4 15-minute time-based units in an hour for both Medicare patients and commercial insurance patients just using one therapist or one therapist/therapy assistant and not using any support personnel.
Let’s begin!
Question
Can you bill 5 15-minute time-based units in an hour with Medicare patients?
Answer
The content here is for members only log in here or sign up.
Question
Can you bill 6 15-time-based units in an hour?
Answer
The content here is for members only log in here or sign up.
Question
Is it possible to bill 7 15-minute time-based units in an hour?
Answer
The content here is for members only log in here or sign up.
Question
Is it possible to bill more than 32 15-minute time-based units in an 8-hour workday?
Answer
The content here is for members only log in here or sign up.
I hope you found this article helpful in showing you how it’s possible to legally bill more than 4 15-minute time-based units in an hour. Thank you for being a Gold Member!
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Check Our Past Webinars!
Leave a Reply
Your email address will not be published. Required fields are marked *This site uses Akismet to reduce spam. Learn how your comment data is processed.
Our company has a gold membership. Is there any way I can get logged on without knowing what the other person put in for a password?
No
We had claims deny due to more than 6 units of 97530 for one pt on one day. However, the units are split between PT and OT with appropriate modifiers (-GP & -GO) on the claim. Is there a step we are missing?
The simple answer is an insurance carrier could limit the number of units of a specific CPT code reimbursed on the same day by either the same discipline or the same practice or organization. Who was the insurance carrier?
The carrier is Medicare
Stay tuned for my article that I will publish next Monday.
Do you have a list of what insurances follow AMA billing guidelines?
No, since there are so many insurance carriers. You will need to read the applicable therapy policies of the insurance carrier plus your contract.
question reading through this article when you get to the examples, you only have 30 minutes of treatment time but you are billing 3 CPT codes. It was my impression that you needed 38 minutes or more total time to bill 3 codes? Does the 23min and 38min only apply to billing the same code?
Read above the answer and it will explain how. You may also want to read this article:
https://gawendaseminars.com/what-is-substantial-of-a-time-based-cpt-code-2/